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Hoving AM, Mikhal J, Kuipers H, de Borst GJ, Slump CH. Development of an in vitro setup for flow studies in a stented carotid artery bifurcation. Med Biol Eng Comput 2024; 62:1165-1176. [PMID: 38155315 DOI: 10.1007/s11517-023-02977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023]
Abstract
To investigate flow conditions in a double-layered carotid artery stent, a bench-top in vitro flow setup including a bifurcation phantom was designed and fabricated. The geometry of the tissue-mimicking phantom was based on healthy individuals. Two identical phantoms were created using 3D-printing techniques and molding with PVA-gel. In one of them, a clinically available CGuard double-layer stent was inserted. Measurements were performed using both continuous and pulsatile flow conditions. Blood flow studies were performed using echoPIV: a novel ultrasound-based technique combined with particle image velocimetry. A maximum deviation of 3% was visible between desired and measured flow patterns. The echoPIV measurements showed promising results on visualization and quantification of blood flow in and downstream the stent. Further research could demonstrate the effects of a double-layered stent on blood flow patterns in a carotid bifurcation in detail.
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Affiliation(s)
- Astrid M Hoving
- Robotics and Mechatronics Group, TechMed Centre, University of Twente, 7500 AE, Enschede, The Netherlands.
| | - Julia Mikhal
- Health Technology and Services Research Group, TechMed Centre, University of Twente, 7500 AE, Enschede, The Netherlands
| | - Henny Kuipers
- Robotics and Mechatronics Group, TechMed Centre, University of Twente, 7500 AE, Enschede, The Netherlands
| | - Gert J de Borst
- Department of Vascular Surgery, University Medical Centre Utrecht, 3584 CX, Utrecht, The Netherlands
| | - Cornelis H Slump
- Robotics and Mechatronics Group, TechMed Centre, University of Twente, 7500 AE, Enschede, The Netherlands
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van Helvert M, Engelhard S, Voorneveld J, van der Vee M, Bosch JG, Versluis M, Groot Jebbink E, Reijnen MMPJ. High-frame-rate contrast-enhanced ultrasound particle image velocimetry in patients with a stented superficial femoral artery: a feasibility study. Eur Radiol Exp 2022; 6:32. [PMID: 35790584 PMCID: PMC9256892 DOI: 10.1186/s41747-022-00278-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background Local blood flow affects vascular disease and outcomes of endovascular treatment, but quantifying it is challenging, especially inside stents. We assessed the feasibility of blood flow quantification in native and stented femoral arteries, using high-frame-rate (HFR) contrast-enhanced ultrasound (CEUS) particle image velocimetry (PIV), also known as echoPIV. Methods Twenty-one patients with peripheral arterial disease, recently treated with a stent in the femoral artery, were included. HFR CEUS measurements were performed in the native femoral artery and at the inflow and outflow of the stent. Two-dimensional blood flow was quantified through PIV analysis. EchoPIV recordings were visually assessed by five observers and categorised as optimal, partial, or unfeasible. To evaluate image quality and tracking performance, contrast-to-tissue ratio (CTR) and vector correlation were calculated, respectively. Results Fifty-eight locations were measured and blood flow quantification was established in 49 of them (84%). Results were optimal for 17/58 recordings (29%) and partial for 32 recordings (55%) due to loss of correlation (5/32; 16%), short vessel segment (8/32; 25%), loss of contrast (14/32; 44%), and/or shadows (18/32; 56%). In the remaining 9/58 measurements (16%) no meaningful flow information was visualised. Overall, CTR and vector correlation were lower during diastole. CTR and vector correlation were not different between stented and native vessel segments, except for a higher native CTR at the inflow during systole (p = 0.037). Conclusions Blood flow quantification is feasible in untreated and stented femoral arteries using echoPIV. Limitations remain, however, none of them related to the presence of the stent. Trial registration ClinicalTrials.gov, NCT04934501 (retrospectively registered). Supplementary Information The online version contains supplementary material available at 10.1186/s41747-022-00278-w.
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Affiliation(s)
- Majorie van Helvert
- Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands. .,Department of Vascular Surgery, Rijnstate Hospital, Arnhem, The Netherlands. .,Physics of Fluids Group, TechMed Centre, University of Twente, Enschede, The Netherlands.
| | - Stefan Engelhard
- Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands.,Department of Vascular Surgery, Rijnstate Hospital, Arnhem, The Netherlands.,Physics of Fluids Group, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Jason Voorneveld
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marije van der Vee
- Department of Vascular Surgery, Rijnstate Hospital, Arnhem, The Netherlands.,Physics of Fluids Group, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Johan G Bosch
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Michel Versluis
- Physics of Fluids Group, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Erik Groot Jebbink
- Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands.,Department of Vascular Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Michel M P J Reijnen
- Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands.,Department of Vascular Surgery, Rijnstate Hospital, Arnhem, The Netherlands
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